| NPI | 1053870907 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX T6077) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: GA 96559) |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2024-05-01 |