| NPI | 1124095021 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: GA 062122) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: GA 062122) |
| 208D00000X General Practice (Licence: GA 062122) | |
| Enumeration Date | 2006-03-01 |
| Last Update Date | 2017-01-02 |