| NPI | 1275096679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX V7665) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD478553) |
| Enumeration Date | 2019-04-11 |
| Last Update Date | 2025-10-30 |