| NPI | 1609079409 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2017007800) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125-049-138) |
| 208000000X Pediatrics (Licence: IL 125-049-138) | |
| 208000000X Pediatrics (Licence: TX P7810) | |
| 208000000X Pediatrics (Licence: MO 2017007800) | |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2020-03-24 |