| NPI | 1912014440 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD60635735) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 40461) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2021-02-16 |