| NPI | 1568758126 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX R0617) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PR 19911) |
| Enumeration Date | 2011-06-22 |
| Last Update Date | 2017-05-06 |