| NPI | 1063510329 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME52202) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME52202) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2015-08-17 |