| NPI | 1548572696 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 63334) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT197580) |
| 208000000X Pediatrics (Licence: PA MT197580) | |
| 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: WI 63334) | |
| 208000000X Pediatrics (Licence: WI 63334) | |
| Enumeration Date | 2010-07-06 |
| Last Update Date | 2016-02-04 |