| NPI | 1720399074 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 174400000X Specialist (Licence: MA 257755) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 245543) | 
| Enumeration Date | 2010-07-01 | 
| Last Update Date | 2016-09-02 |