| NPI | 1558368522 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2010-01832) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA 067916L) |
| 207R00000X Internal Medicine (Licence: PA MD067916-L) | |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2011-05-04 |