| NPI | 1174904148 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: GA 80692) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301107553) |
| 208D00000X General Practice (Licence: GA 80692) | |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2021-08-05 |