| NPI | 1639462989 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 47748) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KY 47748) |
| Enumeration Date | 2011-05-19 |
| Last Update Date | 2015-09-15 |