| NPI | 1316471030 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX T3307) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD474201) |
| 208D00000X General Practice (Licence: PA MD474201) | |
| Enumeration Date | 2017-04-19 |
| Last Update Date | 2021-12-10 |