| NPI | 1205465705 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD.MD.61422980) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX BP10070694) |
| Enumeration Date | 2020-04-06 |
| Last Update Date | 2023-06-01 |