| NPI | 1104117753 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101258546) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101258546) |
| Enumeration Date | 2011-04-29 |
| Last Update Date | 2015-12-02 |