| NPI | 1609280742 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA OP61036209) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AZ R2399) |
| Enumeration Date | 2014-06-17 |
| Last Update Date | 2020-09-25 |