| NPI | 1386093672 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX 34728) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT211153) |
| Enumeration Date | 2016-06-07 |
| Last Update Date | 2025-11-13 |