| NPI | 1063404457 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301074916) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301074916) |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2022-07-21 |