| NPI | 1912993650 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX M5328) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TN MD38309) |
| Enumeration Date | 2005-09-27 |
| Last Update Date | 2023-03-10 |