| NPI | 1720170210 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101255662) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 55137-20) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2014-04-02 |