| NPI | 1124400494 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX R8272) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2015019340) |
| Enumeration Date | 2015-06-23 |
| Last Update Date | 2021-09-02 |