| NPI | 1790779007 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NM 93385) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX J0249) |
| Enumeration Date | 2005-09-01 |
| Last Update Date | 2007-07-08 |