| NPI | 1629260534 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD60580586) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WY 8456A) |
| Enumeration Date | 2007-08-14 |
| Last Update Date | 2015-11-25 |