| NPI | 1538653035 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX T2379) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD475444) |
| Enumeration Date | 2018-06-18 |
| Last Update Date | 2026-01-08 |