| NPI | 1316200447 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME135949)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 284316)  | 
| 207R00000X Internal Medicine (Licence: PA MD456915)  | |
| Enumeration Date | 2012-06-22 | 
| Last Update Date | 2019-01-29 |