| NPI | 1912212150 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD60595315) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 36763) |
| Enumeration Date | 2010-08-12 |
| Last Update Date | 2020-12-07 |