| NPI | 1003891367 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 9788) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PR 9788) |
| Enumeration Date | 2005-12-09 |
| Last Update Date | 2019-05-08 |