| NPI | 1629708656 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX W0867) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT226629) |
| Enumeration Date | 2022-06-13 |
| Last Update Date | 2025-09-11 |