| NPI | 1033195573 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME115092) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 042457) |
| 207R00000X Internal Medicine (Licence: MA 250505) | |
| Enumeration Date | 2005-12-16 |
| Last Update Date | 2019-01-04 |