| NPI | 1124478755 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0089481) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT211992) |
| 2080S0010X Pediatrics, Sports Medicine (Licence: PA MT211992) | |
| Enumeration Date | 2016-06-14 |
| Last Update Date | 2020-06-15 |