| NPI | 1639444060 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA ML 60292238) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AK 6701) |
| Enumeration Date | 2012-03-19 |
| Last Update Date | 2015-05-28 |