| NPI | 1750362943 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD60775275) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AZ 17754) |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2017-10-25 |