| NPI | 1831766187 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD61529093) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IA R-12146) |
| Enumeration Date | 2021-06-07 |
| Last Update Date | 2024-09-16 |