| NPI | 1861759896 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA 60445634) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A113718) |
| Enumeration Date | 2012-04-16 |
| Last Update Date | 2021-08-02 |