| NPI | 1902028913 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301054607) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MI 4301054607) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2021-10-02 |