| NPI | 1952763146 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 52708) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY R4188) |
| Enumeration Date | 2016-03-25 |
| Last Update Date | 2019-07-30 |