| NPI | 1407831167 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA 60034318) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX M0966) |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2022-03-25 |