| NPI | 1073969986 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX T1334) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 297698) |
| Enumeration Date | 2016-05-10 |
| Last Update Date | 2022-02-25 |