| NPI | 1770746216 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX P0298) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KY 43618) |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2019-10-22 |