| NPI | 1619216124 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA 323962) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 50563) |
| 207R00000X Internal Medicine (Licence: NY 284848) | |
| Enumeration Date | 2013-02-04 |
| Last Update Date | 2021-11-04 |