| NPI | 1649404898 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WI 75555) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD60280020) |
| 2080A0000X Pediatrics, Adolescent Medicine (Licence: MI 4301108168) | |
| Enumeration Date | 2009-05-02 |
| Last Update Date | 2021-09-21 |