| NPI | 1316988769 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX P9118) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AZ 30834) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2020-10-13 |