| NPI | 1063675940 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX P3084) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 258392) |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2013-08-09 |