| NPI | 1518124114 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WY 10050A) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WY 10050A) |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2021-06-07 |