| NPI | 1972693299 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: GA 060103) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX M3418) |
| Enumeration Date | 2006-10-15 |
| Last Update Date | 2020-05-29 |