| NPI | 1770842130 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX T7472) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MS 26085) |
| Enumeration Date | 2012-05-04 |
| Last Update Date | 2023-06-27 |