| NPI | 1629187273 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0000X Family Medicine, Adolescent Medicine (Licence: MA 53346) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 53346) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2007-07-08 |