| NPI | 1740664457 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2018028998)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LT03549)  | 
| Enumeration Date | 2015-07-13 | 
| Last Update Date | 2022-06-06 |