| 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 |