| NPI | 1578508974 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 39555) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KY 39555) |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2021-01-22 |