| NPI | 1568591923 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA md60907503) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MD D68930) |
| 208000000X Pediatrics (Licence: GA 64364) | |
| Enumeration Date | 2007-03-03 |
| Last Update Date | 2020-01-29 |