| NPI | 1972588788 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME110163) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 0428411) |
| 208000000X Pediatrics (Licence: KS 0428411) | |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2014-09-18 |