| NPI | 1912325150 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 55719) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM RS2014-0458) |
| Enumeration Date | 2014-04-04 |
| Last Update Date | 2022-07-21 |