| NPI | 1306836093 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2018-01071) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2018-01071) |
| 207R00000X Internal Medicine (Licence: MA 207692) | |
| 208000000X Pediatrics (Licence: MA 207692) | |
| Enumeration Date | 2005-10-25 |
| Last Update Date | 2021-05-11 |