| NPI | 1679836555 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME149906) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX Q3473) |
| Enumeration Date | 2012-06-16 |
| Last Update Date | 2021-10-26 |