| NPI | 1003142555 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME107535) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10025229) |
| 208000000X Pediatrics (Licence: FL ME107535) | |
| Enumeration Date | 2009-10-19 |
| Last Update Date | 2022-09-27 |