| NPI | 1659661551 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD61660739) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX P6730) |
| Enumeration Date | 2011-04-12 |
| Last Update Date | 2025-06-06 |