| NPI | 1023632528 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX W1389) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A187196) |
| Enumeration Date | 2020-06-01 |
| Last Update Date | 2025-12-08 |