| NPI | 1609810217 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX G1747) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: GA 21883) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2013-09-10 |