| NPI | 1104055102 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NE 28208) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 050472) |
| Enumeration Date | 2009-07-11 |
| Last Update Date | 2015-11-18 |