| NPI | 1700973476 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OR DO153927) |
| Additional Taxonomies | 208D00000X General Practice (Licence: WA OP00001944) |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2014-06-03 |