| NPI | 1003819152 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA 023673) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: LA 023673) |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2008-01-28 |