| NPI | 1962845255 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX R1130) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10046580) |
| 208000000X Pediatrics (Licence: TX BP10046580) | |
| Enumeration Date | 2013-04-17 |
| Last Update Date | 2021-06-30 |