| NPI | 1588079958 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: TX R2142) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX R2142) |
| 207Q00000X Family Medicine (Licence: GA 6997) | |
| Enumeration Date | 2014-06-24 |
| Last Update Date | 2022-09-08 |