| NPI | 1053458315 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MD D0091208) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CO 37716) |
| 208000000X Pediatrics (Licence: VA 0101272348) | |
| 2080A0000X Pediatrics, Adolescent Medicine (Licence: CO 37716) | |
| 2080A0000X Pediatrics, Adolescent Medicine (Licence: MD D0091208) | |
| 2080A0000X Pediatrics, Adolescent Medicine (Licence: VA 0101272348) | |
| 208D00000X General Practice (Licence: CO 37716) | |
| 208D00000X General Practice (Licence: VA 0101272348) | |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2021-07-09 |