| NPI | 1659373231 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM NM83-66) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: NM nm83-66) |
| Enumeration Date | 2005-08-12 |
| Last Update Date | 2007-07-09 |