| NPI | 1790089480 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0101247404) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX P0983) |
| Enumeration Date | 2011-01-10 |
| Last Update Date | 2014-05-14 |