| NPI | 1962698159 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD00048552) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: UT 6348743-1205) |
| Enumeration Date | 2007-09-20 |
| Last Update Date | 2015-01-28 |