| NPI | 1750958955 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: GA 99383) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX V8353) |
| 208000000X Pediatrics (Licence: GA 12904) | |
| Enumeration Date | 2021-06-07 |
| Last Update Date | 2025-06-02 |