| NPI | 1548453954 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX N5403) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL 102491) |
| Enumeration Date | 2007-08-20 |
| Last Update Date | 2019-11-27 |