| NPI | 1639517287 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX T3152) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 285392) |
| Enumeration Date | 2013-06-05 |
| Last Update Date | 2024-09-13 |