| NPI | 1558659060 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX R4349) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 34) |
| 2080H0002X (Licence: OH 34-010201) | |
| 2080H0002X (Licence: OH 34) | |
| 2080H0002X (Licence: TX R4349) | |
| Enumeration Date | 2011-07-18 |
| Last Update Date | 2024-10-03 |