| NPI | 1679849640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD50662894) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MT MED-PHYS-LIC-102284) |
| Enumeration Date | 2012-03-23 |
| Last Update Date | 2021-11-02 |