| NPI | 1831683515 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: SC 82305) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT018713) |
| Enumeration Date | 2018-06-18 |
| Last Update Date | 2022-07-19 |