| NPI | 1699192658 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD60760222) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA ML 60469777) |
| Enumeration Date | 2014-03-27 |
| Last Update Date | 2018-03-17 |