| NPI | 1902909872 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0110840635) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV 590) |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2014-01-23 |