| NPI | 1730296351 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OR MD 26070) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD00045407) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2007-07-08 |