| NPI | 1164483350 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 103680)  | 
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: MO 103680)  | 
| Enumeration Date | 2006-03-29 | 
| Last Update Date | 2014-01-08 |