| NPI | 1790910040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 256722) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 256722) |
| Enumeration Date | 2009-05-15 |
| Last Update Date | 2020-03-02 |