| NPI | 1154777332 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PR 21402) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 21402) |
| Enumeration Date | 2016-05-06 |
| Last Update Date | 2022-11-01 |