| NPI | 1104873801 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA G85529) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 78132) |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2011-10-26 |