| NPI | 1366763666 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX S1338) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 271324) |
| 208000000X Pediatrics (Licence: VA 0116022187) | |
| Enumeration Date | 2010-06-21 |
| Last Update Date | 2019-07-30 |