| NPI | 1891752168 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301089425) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ZZ 116) |
| Enumeration Date | 2006-04-28 |
| Last Update Date | 2022-01-31 |