| NPI | 1760757728 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 260169) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 64413) |
| Enumeration Date | 2012-03-09 |
| Last Update Date | 2019-12-30 |