| NPI | 1821194119 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL 94513) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK 23932) |
| 208000000X Pediatrics (Licence: FL 94513) | |
| 208000000X Pediatrics (Licence: OK 23932) | |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2007-07-08 |