| NPI | 1609155183 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME128755) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR 28913-R) |
| Enumeration Date | 2011-08-15 |
| Last Update Date | 2019-08-30 |