| NPI | 1679957781 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MS 35434) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 69485) |
| 208000000X Pediatrics (Licence: TX V1172) | |
| Enumeration Date | 2015-07-17 |
| Last Update Date | 2025-07-07 |