| NPI | 1265449060 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WY 12406A) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX J5094) |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2020-01-23 |