| NPI | 1679571525 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TN DO2875) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA 20A8866) |
| 208000000X Pediatrics (Licence: TX M5518) | |
| 208000000X Pediatrics (Licence: KY 03632) | |
| Enumeration Date | 2005-07-13 |
| Last Update Date | 2020-10-15 |