| NPI | 1700084555 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX P6342) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AL 29656) |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2021-04-01 |