| NPI | 1336147776 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TN 55900) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 55900) |
| 207R00000X Internal Medicine (Licence: KY 34099) | |
| 208000000X Pediatrics (Licence: KY 34099) | |
| Enumeration Date | 2005-07-11 |
| Last Update Date | 2019-03-11 |