| NPI | 1346582905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX S1645) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: UT 9195404) |
| 2080P0008X Pediatrics, Neurodevelopmental Disabilities (Licence: TX S1645) | |
| Enumeration Date | 2013-03-21 |
| Last Update Date | 2019-08-15 |