| NPI | 1689628893 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 050822) |
| Additional Taxonomies | 208D00000X General Practice (Licence: GA 050822) |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2011-05-20 |