| NPI | 1578848040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 4959) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 4959) |
| Enumeration Date | 2011-10-17 |
| Last Update Date | 2021-10-28 |