| NPI | 1003802554 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME106941) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2005-00328) |
| Enumeration Date | 2005-09-21 |
| Last Update Date | 2021-11-19 |