| NPI | 1033407655 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX S6154) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: GA 72544) |
| Enumeration Date | 2011-07-17 |
| Last Update Date | 2022-01-25 |