| NPI | 1376536862 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: FL ME108341) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV 17433) |
| Enumeration Date | 2005-08-30 |
| Last Update Date | 2017-03-13 |