| NPI | 1013017961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: KS 04-12345) |
| Additional Taxonomies | 208D00000X General Practice (Licence: AZ 55164) |
| 208000000X Pediatrics (Licence: NM 95360) | |
| 208D00000X General Practice (Licence: OK 17696) | |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2025-03-05 |