| NPI | 1922292630 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2014029658) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2014029658) | 
| Enumeration Date | 2007-09-06 | 
| Last Update Date | 2018-03-12 |