| NPI | 1558719039 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX S1055) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX BP10057571) |
| Enumeration Date | 2016-05-25 |
| Last Update Date | 2025-03-18 |