| NPI | 1679763544 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD60250989) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD432327) |
| Enumeration Date | 2007-07-27 |
| Last Update Date | 2012-08-09 |