| NPI | 1558795542 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR MD204019) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR MD204019) |
| 207Q00000X Family Medicine (Licence: UT 10955768-1205) | |
| Enumeration Date | 2013-08-26 |
| Last Update Date | 2021-07-27 |