| NPI | 1861836728 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD60683418) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX 23098759) |
| Enumeration Date | 2013-04-23 |
| Last Update Date | 2021-08-24 |