| NPI | 1255969093 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD.61605796) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX U3505) |
| Enumeration Date | 2020-03-28 |
| Last Update Date | 2025-03-23 |