| NPI | 1982758884 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA G55862) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA G55862) |
| 207R00000X Internal Medicine (Licence: CA G55862) | |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2012-01-06 |