| NPI | 1679792907 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: TX N3068) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX N3068) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2015-01-14 |