| NPI | 1104437136 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 22777) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR 15607-I) |
| Enumeration Date | 2020-08-13 |
| Last Update Date | 2022-07-12 |