NPI | 1457610404 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2080H0002X (Licence: TN 61719) |
Additional Taxonomies | 208000000X Pediatrics (Licence: TX Q3224) |
2080H0002X (Licence: WA 60850593) | |
Enumeration Date | 2012-05-11 |
Last Update Date | 2020-08-12 |