| NPI | 1154373967 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IA 25942) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 25501) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2009-11-25 |