| NPI | 1083690952 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME111545) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 038274) |
| 207R00000X Internal Medicine (Licence: NY 219081-1) | |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2019-11-27 |