| NPI | 1730610114 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX S8307) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: GA 97108) |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2023-09-30 |