| NPI | 1104504042 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2023019631) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2023019631) |
| Enumeration Date | 2023-07-10 |
| Last Update Date | 2023-07-10 |