| NPI | 1124479720 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 279290) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL TRN # 23210) |
| Enumeration Date | 2016-06-24 |
| Last Update Date | 2020-07-06 |