| NPI | 1659717569 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 76650) |
| Additional Taxonomies | 204R00000X Electrodiagnostic Medicine (Licence: GA 76650) |
| 207R00000X Internal Medicine (Licence: PA OTO15170) | |
| Enumeration Date | 2013-05-18 |
| Last Update Date | 2021-08-25 |