| NPI | 1760626543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 57574) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 57574) |
| Enumeration Date | 2009-04-24 |
| Last Update Date | 2020-11-10 |