| NPI | 1912565722 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036163112) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL82607) |
| 208000000X Pediatrics (Licence: SC LL82607) | |
| Enumeration Date | 2019-06-05 |
| Last Update Date | 2023-10-23 |