| NPI | 1629034640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX M0836) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KS 0430589) |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2018-10-10 |