| NPI | 1922504786 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX T0472) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CO DR.0074324) |
| Enumeration Date | 2018-04-02 |
| Last Update Date | 2025-09-25 |