| NPI | 1740267384 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MI 4301058684) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MI 4301058684) |
| Enumeration Date | 2005-12-26 |
| Last Update Date | 2022-10-05 |