| NPI | 1417319203 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 286903) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX s1311) |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2024-05-29 |