| NPI | 1386642056 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301051927) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301051927) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2011-06-28 |