| NPI | 1174879076 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: MN 62447) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 251838) |
| 2085R0001X (Licence: CA A129905) | |
| Enumeration Date | 2012-07-28 |
| Last Update Date | 2020-08-19 |