| NPI | 1962673301 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX N6743) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 253271) |
| Enumeration Date | 2008-03-13 |
| Last Update Date | 2024-01-26 |