| NPI | 1548791171 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: UT 10956995-1205) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: UT 10956995-1205) |
| Enumeration Date | 2017-03-24 |
| Last Update Date | 2022-06-01 |