| NPI | 1649386574 |
|---|---|
| Doing Business As | |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 43464) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 36-103469) |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2024-08-14 |