| NPI | 1710482674 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD61479614) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A167130) |
| Enumeration Date | 2018-03-23 |
| Last Update Date | 2026-04-03 |