| NPI | 1790130813 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MT218943) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.069517) |
| Enumeration Date | 2016-04-26 |
| Last Update Date | 2020-09-23 |