| NPI | 1235143447 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 34003) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 44665) |
| 207R00000X Internal Medicine (Licence: AK 5253) | |
| 208000000X Pediatrics (Licence: MN 34003) | |
| 208000000X Pediatrics (Licence: WI 44665) | |
| 208000000X Pediatrics (Licence: AK 5253) | |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2012-07-26 |