| NPI | 1245790062 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME159605) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PR 040-P.A.) |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2024-08-08 |