| NPI | 1720214513 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD 60624082) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IA 40115) |
| 208000000X Pediatrics (Licence: IA R-8685) | |
| Enumeration Date | 2009-06-07 |
| Last Update Date | 2020-10-09 |