| NPI | 1649357864 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD00034651) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OR MD14363) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2007-07-10 |