| NPI | 1083722904 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MO 2014024074) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 41811) |
| 208000000X Pediatrics (Licence: KY 41811) | |
| 207R00000X Internal Medicine (Licence: MO 2014024074) | |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2014-08-13 |