| NPI | 1104180587 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 93150) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 53611) |
| 207R00000X Internal Medicine (Licence: IA MD-45028) | |
| Enumeration Date | 2012-06-29 |
| Last Update Date | 2022-08-19 |