| NPI | 1942720149 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: NC 2022-01359) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 272856) |
| 2085R0001X (Licence: NC 238339) | |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2022-08-31 |