| NPI | 1588754188 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 51044) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: UT 271434-1205) |
| 207Q00000X Family Medicine (Licence: HI MD 14438) | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2012-06-20 |