| NPI | 1568156933 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2085R0001X  (Licence: OH 57.257578)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R-12744)  | 
| Enumeration Date | 2023-06-07 | 
| Last Update Date | 2024-06-20 |