| NPI | 1245293331 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: KY 30299) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: KY 30299) |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2022-11-03 |