| NPI | 1619395449 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 60171) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM MD2017-0599) |
| Enumeration Date | 2014-03-29 |
| Last Update Date | 2018-09-14 |