| NPI | 1164881975 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 83808) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT210107) |
| Enumeration Date | 2016-02-22 |
| Last Update Date | 2019-08-15 |