| NPI | 1902063423 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0102203075) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0102203075) |
| 207R00000X Internal Medicine (Licence: PA OT012237) | |
| 208000000X Pediatrics (Licence: PA OT012237) | |
| 207R00000X Internal Medicine (Licence: PA OS015488) | |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2013-07-23 |