| NPI | 1588743157 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080H0002X (Licence: UT 326759-1205) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: UT 326759-1205) |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2018-06-19 |