| NPI | 1033520291 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MO R1C65) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KS 0430385) |
| 207Q00000X Family Medicine (Licence: KS 0430385) | |
| 207Q00000X Family Medicine (Licence: MO R1C65) | |
| Enumeration Date | 2014-05-09 |
| Last Update Date | 2014-11-03 |