| NPI | 1750639365 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2015021617) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT200802) |
| Enumeration Date | 2012-08-29 |
| Last Update Date | 2015-11-06 |