| NPI | 1104230432 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: SC 36895) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL36895) |
| 208000000X Pediatrics (Licence: SC LL36895) | |
| Enumeration Date | 2014-06-14 |
| Last Update Date | 2018-07-17 |