| NPI | 1023632809 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX U5529) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SC LL83205) |
| Enumeration Date | 2020-06-08 |
| Last Update Date | 2026-02-09 |