| NPI | 1649360439 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX J8999) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX J8999) |
| 207QA0000X Family Medicine Adolescent Medicine (Licence: TX J8999) | |
| 2080A0000X Pediatrics Adolescent Medicine (Licence: TX J8999) | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2024-07-30 |