| NPI | 1508120809 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01078791A) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2012012806) | 
| Enumeration Date | 2012-07-02 | 
| Last Update Date | 2017-08-24 |