| NPI | 1790896355 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 261232) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX M4356) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2015-01-01 |