| NPI | 1639175466 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 246312) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI MD11191) |
| Enumeration Date | 2005-06-27 |
| Last Update Date | 2015-01-08 |