| NPI | 1861487860 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 200301140) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 0101224961) |
| 208000000X Pediatrics (Licence: NC 200301140) | |
| Enumeration Date | 2005-09-15 |
| Last Update Date | 2024-03-11 |