| NPI | 1235101106 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX N7595) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KY 37325) |
| Enumeration Date | 2006-02-06 |
| Last Update Date | 2016-09-17 |