| NPI | 1598880791 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X (Licence: NC 2021-00123) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2021-00123) |
| 208000000X Pediatrics (Licence: NC 2021-00123) | |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2021-12-14 |