| NPI | 1164633715 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: UT 10122609-1205) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX M6258) |
| 208000000X Pediatrics (Licence: MN 51747) | |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2017-01-19 |