| NPI | 1760681340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX V3937) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD60530682) |
| Enumeration Date | 2007-07-13 |
| Last Update Date | 2025-01-22 |