| NPI | 1811208507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD60262140) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX N6332) |
| Enumeration Date | 2010-06-28 |
| Last Update Date | 2012-11-02 |