| NPI | 1801237854 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX R3021) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD61424251) |
| Enumeration Date | 2013-07-07 |
| Last Update Date | 2025-07-09 |