| NPI | 1912054339 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD61096761) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WY 6100A) |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2021-11-08 |