| NPI | 1417918897 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: DE C10000755) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: DE C10000755) |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2015-07-10 |