| NPI | 1912089947 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD60266119) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR MD26913) |
| 208000000X Pediatrics (Licence: OR MD26913) | |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2015-05-26 |