| NPI | 1629399928 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX S9354) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME117552) |
| Enumeration Date | 2010-06-21 |
| Last Update Date | 2021-01-09 |