| NPI | 1619102787 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: WA MD60552942) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL TRN14152) |
| 208000000X Pediatrics (Licence: WA MD60552942) | |
| Enumeration Date | 2009-05-19 |
| Last Update Date | 2015-08-03 |