| NPI | 1023048196 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA C54529) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX L8495) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2020-09-08 |