| NPI | 1699334987 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MT MED-PHYS-LIC-144346) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MT MED-PHYS-LIC-144346) |
| 261QS1000X Clinic/Center Student Health | |
| Enumeration Date | 2019-06-10 |
| Last Update Date | 2024-08-21 |