| NPI | 1962697326 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX M9525) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 245906) |
| Enumeration Date | 2007-09-10 |
| Last Update Date | 2018-05-18 |