| NPI | 1811191646 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX N9712) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2010-00790) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2016-08-09 |