| NPI | 1326048562 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA MD.204734) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WV 19549) |
| 207R00000X Internal Medicine (Licence: WV 19549) | |
| 208000000X Pediatrics (Licence: LA MD.204734) | |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2022-08-25 |