| NPI | 1750571956 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: GA 78683) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301089798) |
| Enumeration Date | 2007-07-25 |
| Last Update Date | 2020-09-16 |