| NPI | 1447270061 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: KY 37133) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KY 37133) |
| 208000000X Pediatrics (Licence: OH 53964) | |
| 208000000X Pediatrics (Licence: LA MD.015365) | |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2020-11-27 |