| NPI | 1154775609 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA OT016971) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WY 12240A) |
| Enumeration Date | 2016-04-21 |
| Last Update Date | 2021-12-09 |