| NPI | 1710155163 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV 12906) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301084322) |
| 208000000X Pediatrics (Licence: MI 4301084322) | |
| 208000000X Pediatrics (Licence: NV 12906) | |
| Enumeration Date | 2008-02-19 |
| Last Update Date | 2010-01-22 |