| NPI | 1811025786 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX N1380) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 240345) |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2011-08-17 |