| NPI | 1154496040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VI SP1377) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 251287) |
| 207R00000X Internal Medicine (Licence: WI 52351-20) | |
| 208000000X Pediatrics (Licence: WI 52351-20) | |
| 208000000X Pediatrics (Licence: MA 251287) | |
| 208000000X Pediatrics (Licence: VI SP1377) | |
| Enumeration Date | 2006-11-23 |
| Last Update Date | 2020-04-27 |