| NPI | 1962997510 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 78284) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 77321-20) |
| 208000000X Pediatrics (Licence: WI 77321-20) | |
| 208000000X Pediatrics (Licence: MN 78284) | |
| Enumeration Date | 2018-06-26 |
| Last Update Date | 2024-10-28 |