| NPI | 1922455997 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY TP337) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KY TP337) |
| Enumeration Date | 2016-05-19 |
| Last Update Date | 2020-10-12 |