| NPI | 1700370863 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: MO 2020042128) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2020042128) |
| Enumeration Date | 2018-06-21 |
| Last Update Date | 2022-04-04 |