| NPI | 1114509650 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL 175086) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VT 0420017989) |
| 208000000X Pediatrics (Licence: CO CDR.0005149) | |
| 208000000X Pediatrics (Licence: WY TL8632) | |
| 208000000X Pediatrics (Licence: TX V6597) | |
| Enumeration Date | 2021-04-23 |
| Last Update Date | 2025-09-29 |