| NPI | 1801888524 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD00046330) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OR MD23090) |
| Enumeration Date | 2005-08-18 |
| Last Update Date | 2012-02-09 |