| NPI | 1619168317 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA 200431) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: LA 200431) | 
| Enumeration Date | 2007-08-07 | 
| Last Update Date | 2013-02-18 |