| NPI | 1962088310 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX W6417) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CO DR.0072578) |
| Enumeration Date | 2021-03-23 |
| Last Update Date | 2026-08-28 |