| NPI | 1700839941 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2005-00244) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 200500244) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2021-08-10 |