| NPI | 1730164328 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 275381) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD60410099) |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2019-03-01 |