| NPI | 1285969667 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 1089316) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MO 1089316) |
| Enumeration Date | 2009-10-02 |
| Last Update Date | 2019-07-11 |