| NPI | 1568620532 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA C193521) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX P0782) |
| Enumeration Date | 2008-05-27 |
| Last Update Date | 2024-07-21 |