| NPI | 1386658128 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RA0000X Internal Medicine, Adolescent Medicine (Licence: SC 22084) |
| Additional Taxonomies | 207RA0000X Internal Medicine, Adolescent Medicine (Licence: NC 200001720) |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2011-01-13 |