| NPI | 1871627158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX N8540) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101241373) |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2014-11-30 |