| NPI | 1760624340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2015-01628) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA 60093395) |
| Enumeration Date | 2009-03-30 |
| Last Update Date | 2016-03-01 |