| NPI | 1881109585 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX T8697) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 19798) |
| 208D00000X General Practice (Licence: PR 14132-I) | |
| Enumeration Date | 2017-12-05 |
| Last Update Date | 2022-11-02 |