| NPI | 1205861754 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0000X Internal Medicine, Adolescent Medicine (Licence: KY 34221) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KY 34221) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2023-03-01 |