| NPI | 1689613838 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX N3537) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 204445) |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2021-01-14 |