| NPI | 1568716496 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ARNP9247687) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ARNP9247687) |
| Enumeration Date | 2012-10-30 |
| Last Update Date | 2012-10-30 |