| NPI | 1760480883 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 43010055130) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 43010055130) |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2025-08-11 |