| NPI | 1568873909 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX S8184) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: ZZ 12801) |
| Enumeration Date | 2014-05-19 |
| Last Update Date | 2024-06-03 |