| NPI | 1578805461 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: ID O-0929) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ID MRO-1341) |
| Enumeration Date | 2013-03-19 |
| Last Update Date | 2022-06-27 |