| NPI | 1669636304 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX P0326)  | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 235521)  | 
| Enumeration Date | 2008-07-11 | 
| Last Update Date | 2018-08-03 |