| NPI | 1750388971 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX G4785) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 01022011441) |
| Enumeration Date | 2005-07-01 |
| Last Update Date | 2022-07-21 |