| NPI | 1962407031 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TN MD031364) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX K5328) |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2013-02-14 |