| NPI | 1649412974 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WV 55025) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 55025) |
| Enumeration Date | 2009-04-01 |
| Last Update Date | 2013-06-24 |