| NPI | 1164780011 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WV 32889) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 280504) |
| Enumeration Date | 2012-04-29 |
| Last Update Date | 2025-02-20 |