| NPI | 1760034979 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD C0007210) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C07210) |
| Enumeration Date | 2019-07-09 |
| Last Update Date | 2019-08-12 |