| NPI | 1710977111 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101047338) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV 19871) |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2021-03-20 |