| NPI | 1649360439 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX J8999)  | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX J8999)  | 
| 207QA0000X Family Medicine, Adolescent Medicine (Licence: TX J8999)  | |
| 2080A0000X Pediatrics, Adolescent Medicine (Licence: TX j8999)  | |
| Enumeration Date | 2006-10-13 | 
| Last Update Date | 2024-07-30 |