| NPI | 1104355643 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 173100) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA 173100) |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2021-11-03 |