| NPI | 1063783116 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 201301805) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 265950) |
| 207R00000X Internal Medicine (Licence: WV 25126) | |
| Enumeration Date | 2012-01-21 |
| Last Update Date | 2013-10-11 |