| NPI | 1467611012 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2008-00448) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2008-00448) |
| Enumeration Date | 2008-06-07 |
| Last Update Date | 2021-04-01 |