| NPI | 1619137700 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX Q0429) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME111039) |
| Enumeration Date | 2008-06-11 |
| Last Update Date | 2020-04-01 |