| NPI | 1740391630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 301639-01) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD 60265069) |
| 208000000X Pediatrics (Licence: OR MD150622) | |
| 208000000X Pediatrics (Licence: CA A91477) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2021-08-06 |