| NPI | 1669449096 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: MI 4301036984) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301036984) |
| 208000000X Pediatrics (Licence: MI 4301036984) | |
| Enumeration Date | 2006-03-03 |
| Last Update Date | 2025-06-23 |