| NPI | 1649364241 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX K2360) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX K2360) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2021-07-07 |