| NPI | 1407841554 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO MD R7B15) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 04-23500) |
| Enumeration Date | 2005-09-14 |
| Last Update Date | 2007-08-14 |