| NPI | 1629557111 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101239997) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA059985) |
| Enumeration Date | 2018-08-07 |
| Last Update Date | 2022-06-09 |