| NPI | 1053554840 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA 206646) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: LA 206646) | 
| Enumeration Date | 2009-04-09 | 
| Last Update Date | 2015-02-19 |