| NPI | 1902105562 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD60458638) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA ML60224481) |
| Enumeration Date | 2011-03-22 |
| Last Update Date | 2021-04-29 |