| NPI | 1740338763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A95702) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA A95702) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2022-07-01 |