| NPI | 1790704583 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KS 04-22476) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO R9H78) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2011-06-29 |