| NPI | 1710368782 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MI 5315069986) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101021683) |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2019-08-13 |