| NPI | 1396191797 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: CT 66345) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 66345) |
| 208000000X Pediatrics (Licence: CT 198369243) | |
| 208000000X Pediatrics (Licence: CT 66345) | |
| Enumeration Date | 2016-05-04 |
| Last Update Date | 2021-02-25 |