| NPI | 1629058748 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA OP00002348) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IA R-7558) |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2025-12-04 |