| NPI | 1902209612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 22207) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: PR 35152-R) |
| 207R00000X Internal Medicine (Licence: PA MT211301) | |
| 207R00000X Internal Medicine (Licence: PA MD467320) | |
| Enumeration Date | 2014-10-08 |
| Last Update Date | 2021-03-12 |