| NPI | 1619915584 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 028850) |
| Additional Taxonomies | 208D00000X General Practice (Licence: GA 028850) |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2016-05-05 |