| NPI | 1043211204 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 47736) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101102663) |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2014-12-23 |