| NPI | 1134768336 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MI 4301507769) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX BP1-0069560) |
| Enumeration Date | 2020-01-06 |
| Last Update Date | 2023-05-01 |