| NPI | 1346227675 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PA MD073432L) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: DE C10006345) |
| 208D00000X General Practice (Licence: DE C10006345) | |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2021-08-03 |