| NPI | 1912342510 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 03980) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY R3236) |
| Enumeration Date | 2013-05-08 |
| Last Update Date | 2016-06-22 |