| NPI | 1639757099 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2025-00244) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: SC 97689) |
| Enumeration Date | 2021-03-29 |
| Last Update Date | 2026-07-24 |