| NPI | 1053510834 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A107419) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A107419) |
| Enumeration Date | 2007-07-12 |
| Last Update Date | 2014-06-09 |