| NPI | 1972861441 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A12833)  | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX q1507)  | 
| Enumeration Date | 2012-05-02 | 
| Last Update Date | 2021-12-06 |