| NPI | 1043891542 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME175150) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX U9216) |
| Enumeration Date | 2021-04-16 |
| Last Update Date | 2025-07-09 |