| NPI | 1699035055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 60089) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 60089) |
| Enumeration Date | 2012-05-19 |
| Last Update Date | 2020-03-23 |