| NPI | 1063948461 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OR MD200180) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX BP10059338) |
| Enumeration Date | 2017-05-04 |
| Last Update Date | 2021-01-26 |