| NPI | 1790711059 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 042480) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CT 042480) |
| Enumeration Date | 2006-06-25 |
| Last Update Date | 2021-10-19 |