| NPI | 1811955537 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2003024655) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2003024655) |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2007-07-08 |