NPI | 1104591304 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD70015826) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 77718) |
207R00000X Internal Medicine (Licence: WI 8805-851) | |
Enumeration Date | 2021-08-10 |
Last Update Date | 2025-09-24 |