| NPI | 1629269311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 1376) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 1376) |
| 207R00000X Internal Medicine (Licence: PA OT011965) | |
| Enumeration Date | 2007-08-07 |
| Last Update Date | 2019-06-28 |