| NPI | 1699189258 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD60739567) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SC LL36843) |
| Enumeration Date | 2014-06-11 |
| Last Update Date | 2020-12-02 |