| NPI | 1063849503 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 5101022447) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL U03559) |
| 208D00000X General Practice (Licence: FL OS 12813) | |
| Enumeration Date | 2013-09-30 |
| Last Update Date | 2016-07-26 |