| NPI | 1568573855 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CO 053797) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD60018670) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2021-06-18 |