| NPI | 1952507519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA MD.202512) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2004020015) |
| 208000000X Pediatrics (Licence: MO 2004020015) | |
| 208000000X Pediatrics (Licence: LA MD.202512) | |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2010-07-20 |