| NPI | 1538233184 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 28114) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KY 28114) |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2020-05-11 |