| NPI | 1902394240 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX s3877) |
| Additional Taxonomies | 208D00000X General Practice (Licence: TX s3877) |
| Enumeration Date | 2018-04-23 |
| Last Update Date | 2022-02-21 |