| NPI | 1063732055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2013-01617) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MD D97797) |
| 208D00000X General Practice (Licence: NC 2013-01617) | |
| Enumeration Date | 2010-06-02 |
| Last Update Date | 2024-07-10 |