| NPI | 1497926604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: NC 2012-00052) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO TL2543) |
| 2085R0001X (Licence: SC 34262) | |
| Enumeration Date | 2008-03-14 |
| Last Update Date | 2012-05-22 |