| NPI | 1871513200 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0000X Family Medicine, Adolescent Medicine (Licence: MA 58075) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 58075) |
| 2080A0000X Pediatrics, Adolescent Medicine (Licence: MA 58075) | |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2019-01-25 |