| NPI | 1700205929 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NE 28985) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NE 28985) |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2023-08-21 |