| NPI | 1912040627 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MD H0069465) |
| Additional Taxonomies | 208D00000X General Practice (Licence: DE C2-0012895) |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2020-09-30 |