| NPI | 1679668792 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: SC TL32293) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 48695) |
| 208000000X Pediatrics (Licence: WI 48695) | |
| 208000000X Pediatrics (Licence: SC TL32293) | |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2020-02-07 |