| NPI | 1962024778 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MS 33023) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS 33023) |
| 207R00000X Internal Medicine (Licence: SC 84112) | |
| 208000000X Pediatrics (Licence: SC 84112) | |
| Enumeration Date | 2020-05-14 |
| Last Update Date | 2024-06-18 |