| NPI | 1306204813 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 53821) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KY 53821) |
| Enumeration Date | 2016-01-29 |
| Last Update Date | 2020-07-28 |