| NPI | 1912149501 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD60276969) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA ML60093389) |
| Enumeration Date | 2009-03-30 |
| Last Update Date | 2013-04-23 |