| NPI | 1689081515 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: KY 55015) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX BP1-0050285) |
| Enumeration Date | 2014-07-11 |
| Last Update Date | 2021-09-02 |