| NPI | 1588874911 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NE 24078) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NE 24078) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2023-09-27 |