| NPI | 1760450886 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CT 037683) |
| Additional Taxonomies | 207QA0000X Family Medicine, Adolescent Medicine (Licence: CT 037683) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2018-03-26 |