| NPI | 1689913543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME140553) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2015021614) |
| Enumeration Date | 2013-02-12 |
| Last Update Date | 2019-08-15 |