| NPI | 1881012615 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD61364163) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OR MD187563) |
| 208000000X Pediatrics (Licence: OH 35129256) | |
| 208000000X Pediatrics (Licence: WI 73355) | |
| Enumeration Date | 2014-03-29 |
| Last Update Date | 2023-11-22 |