| NPI | 1750481792 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: TX M8511) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: VA 010123456) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2020-12-10 |