| NPI | 1174547061 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101246944)  | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CT 041325)  | 
| Enumeration Date | 2006-07-26 | 
| Last Update Date | 2019-12-06 |