| NPI | 1124389564 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX Q7109) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301100985) |
| 208000000X Pediatrics (Licence: KS 04-39397) | |
| Enumeration Date | 2012-06-01 |
| Last Update Date | 2025-09-09 |