| NPI | 1104184159 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: KY 04034) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 04034) |
| Enumeration Date | 2012-04-27 |
| Last Update Date | 2017-01-20 |