| NPI | 1972646479 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX P0911) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WV 21130) |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2022-01-26 |