| NPI | 1821089673 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX V3759) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: LA 020835) |
| Enumeration Date | 2005-11-01 |
| Last Update Date | 2025-03-05 |