| NPI | 1609216936 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: WA 60947484) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 266304) |
| 208000000X Pediatrics (Licence: MO 2013020092) | |
| Enumeration Date | 2013-07-01 |
| Last Update Date | 2020-06-09 |