| NPI | 1871868182 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 95617) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: GA 95617) |
| 207R00000X Internal Medicine (Licence: CT 55280) | |
| 208000000X Pediatrics (Licence: CT 55280) | |
| Enumeration Date | 2012-03-20 |
| Last Update Date | 2023-07-13 |