| NPI | 1639454523 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OR MD171420) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD60346692) |
| Enumeration Date | 2011-10-12 |
| Last Update Date | 2018-10-31 |