| NPI | 1174503296 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: IA 23149) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IA 23149) |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2019-06-10 |