| NPI | 1720122112 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: MA 235985) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 229030) |
| Enumeration Date | 2007-02-18 |
| Last Update Date | 2012-08-13 |