| NPI | 1104591304 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 77718) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 8805-851) |
| Enumeration Date | 2021-08-10 |
| Last Update Date | 2024-09-17 |