| NPI | 1124402268 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX R9300) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PR 33599) |
| Enumeration Date | 2015-07-18 |
| Last Update Date | 2019-06-04 |