| NPI | 1972522019 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD18550) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OR MD18550) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2015-10-20 |