| NPI | 1396744314 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX H6153) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX H6153) |
| Enumeration Date | 2005-07-20 |
| Last Update Date | 2012-04-03 |