| NPI | 1558493098 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD08027) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OR MD08027) |
| Enumeration Date | 2007-03-11 |
| Last Update Date | 2007-07-08 |