| NPI | 1508831876 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX P1458) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101225444) |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2012-01-19 |