| NPI | 1659837631 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX T1183) |
| Additional Taxonomies | 208D00000X General Practice (Licence: TX T1183) |
| Enumeration Date | 2019-02-14 |
| Last Update Date | 2024-01-09 |