| NPI | 1255774741 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: AZ 52546) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX 28850372) |
| Enumeration Date | 2013-04-15 |
| Last Update Date | 2017-03-30 |