| NPI | 1619499548 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 5101026252) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 5101026252) |
| Enumeration Date | 2017-07-12 |
| Last Update Date | 2021-12-15 |