| NPI | 1205916186 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 31386501) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX M0862) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2025-11-16 |