| NPI | 1639475940 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 57191) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 107023) |
| 207R00000X Internal Medicine (Licence: ND 11604) | |
| Enumeration Date | 2011-02-03 |
| Last Update Date | 2021-03-03 |