| NPI | 1861055238 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD61316423) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX BP10066852) |
| Enumeration Date | 2019-04-20 |
| Last Update Date | 2026-03-25 |