NPI | 1013570365 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207QA0000X Family Medicine, Adolescent Medicine (Licence: MI 4301506664) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301506664) |
2080A0000X Pediatrics, Adolescent Medicine (Licence: MI 4301506664) | |
Enumeration Date | 2019-04-22 |
Last Update Date | 2025-09-11 |