| NPI | 1235349044 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX N9018) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 242333) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2018-10-10 |