| NPI | 1649228552 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD418776) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AK 4863) |
| 208D00000X General Practice (Licence: AK 4863) | |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2019-09-10 |