| NPI | 1568456523 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD00049402) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35080491) |
| Enumeration Date | 2005-09-07 |
| Last Update Date | 2011-11-02 |