| NPI | 1962602466 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD60794455) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX BP10028593) |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2021-07-28 |