| NPI | 1700819729 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 38363) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KY 38363) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2015-03-13 |