| NPI | 1720353196 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD60569321) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA ML 60292587) |
| Enumeration Date | 2012-03-18 |
| Last Update Date | 2018-06-16 |