| NPI | 1003099821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC RTL 122324) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC RTL 122324) |
| Enumeration Date | 2007-12-15 |
| Last Update Date | 2012-04-09 |