| NPI | 1952656084 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX Q0193) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX F0015837-463) |
| Enumeration Date | 2012-07-15 |
| Last Update Date | 2019-10-14 |