| NPI | 1487035747 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: WA MD60771644) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 263029) |
| Enumeration Date | 2015-06-12 |
| Last Update Date | 2020-06-09 |