| NPI | 1043296551 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PR 10695) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PR 10695) |
| 208D00000X General Practice (Licence: PR 10695) | |
| Enumeration Date | 2005-12-16 |
| Last Update Date | 2022-07-21 |