| NPI | 1760420863 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD60249785) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: GA 054500) |
| 208000000X Pediatrics (Licence: NV 12186) | |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2012-03-15 |