| NPI | 1619943024 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: ND PT 12429) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD00041126) |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2021-05-14 |