| NPI | 1174956569 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 92939) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0101266097) |
| Enumeration Date | 2013-08-21 |
| Last Update Date | 2023-07-14 |