| NPI | 1821085432 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX M6113) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 38001) |
| Enumeration Date | 2005-09-29 |
| Last Update Date | 2014-07-08 |