| NPI | 1679717672 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD60522342) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NV 14404) |
| Enumeration Date | 2009-04-22 |
| Last Update Date | 2015-03-23 |