| NPI | 1063666758 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: GA 74390) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX P5375) |
| Enumeration Date | 2008-11-09 |
| Last Update Date | 2020-03-20 |