NPI | 1407148224 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 136663) |
Additional Taxonomies | 208000000X Pediatrics (Licence: CA 136663) |
Enumeration Date | 2011-05-12 |
Last Update Date | 2015-11-04 |