| NPI | 1790719011 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WY 13781A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A77195) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2022-02-01 |