| NPI | 1588663942 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208D00000X General Practice (Licence: DE C10006091)  | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: DE C1-0006091)  | 
| Enumeration Date | 2005-07-19 | 
| Last Update Date | 2012-04-04 |