| NPI | 1912111493 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OR NP87006005N2) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA 025804AP30003771) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2007-07-08 |