| NPI | 1033641212 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WV TBD) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WV TBD) |
| Enumeration Date | 2017-03-28 |
| Last Update Date | 2017-03-28 |