| NPI | 1982048708 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OK 29964) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 30940) |
| Enumeration Date | 2013-04-23 |
| Last Update Date | 2021-09-16 |