| NPI | 1780081505 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: DE C10011180) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: DE C100) |
| Enumeration Date | 2014-11-21 |
| Last Update Date | 2014-12-30 |