| NPI | 1972727600 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301085768) |
| Additional Taxonomies | 207RS0010X Internal Medicine, Sports Medicine (Licence: MI 4301085768) |
| 208000000X Pediatrics (Licence: MI 4301085768) | |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2020-10-20 |