| NPI | 1760655575 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: WA MD60273531) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: OR MD158570) |
| Enumeration Date | 2008-04-12 |
| Last Update Date | 2013-02-26 |