| NPI | 1457736761 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX R7642) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KY R3697) |
| Enumeration Date | 2015-07-28 |
| Last Update Date | 2023-01-11 |