| NPI | 1225010861 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WV 22010) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101233309) |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2011-11-10 |