| NPI | 1619183522 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX R5605) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD449761) |
| 208000000X Pediatrics (Licence: CT 046825) | |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2019-03-05 |