| NPI | 1962933382 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX S7552) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA ML60760061) |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2020-07-15 |