| NPI | 1053727602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 04121) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0116027328) |
| Enumeration Date | 2014-07-03 |
| Last Update Date | 2018-03-12 |