| NPI | 1801838966 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: LA MD202561) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD00042179) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2017-01-08 |