| NPI | 1205843505 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NH 11649) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NH 11649) |
| 207R00000X Internal Medicine (Licence: MO 2000146069) | |
| 208000000X Pediatrics (Licence: MO 2000146069) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2012-02-03 |