| NPI | 1861671281 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX P6255) |
| Additional Taxonomies | 208D00000X General Practice (Licence: TX P6255) |
| Enumeration Date | 2007-11-01 |
| Last Update Date | 2021-11-17 |