| NPI | 1619924610 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO 44791) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA 20008329) |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2007-08-27 |