| NPI | 1245541044 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX Q7788) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT198355) |
| Enumeration Date | 2010-06-25 |
| Last Update Date | 2021-03-23 |