| NPI | 1760591622 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD60022454) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ID M-10741) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2021-07-07 |