| NPI | 1124211537 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX N3818) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: LA 201237) |
| Enumeration Date | 2007-08-20 |
| Last Update Date | 2021-04-16 |