| NPI | 1124549464 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV 21901) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: UT 11676932-1205) |
| 207R00000X Internal Medicine (Licence: RI LP04118) | |
| Enumeration Date | 2017-06-27 |
| Last Update Date | 2022-02-24 |