| NPI | 1174551386 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MA052505) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA169945) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2023-04-21 |