| NPI | 1851653091 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: SC 21011) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN155655) |
| Enumeration Date | 2012-06-13 |
| Last Update Date | 2022-07-21 |