| NPI | 1538114921 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 041783) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 041783) | 
| 208D00000X General Practice (Licence: GA 041783) | |
| Enumeration Date | 2006-05-23 | 
| Last Update Date | 2014-01-03 |