| NPI | 1104186006 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX R4203) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KS 94-07898) |
| 208000000X Pediatrics (Licence: NM MD2019-0241) | |
| Enumeration Date | 2012-05-24 |
| Last Update Date | 2020-03-12 |