| NPI | 1174660633 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101233266) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MD D0059466) |
| 208000000X Pediatrics (Licence: DC MD33954) | |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2021-11-23 |