| NPI | 1962463455 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A45394) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA 00A453940) |
| Enumeration Date | 2006-04-01 |
| Last Update Date | 2013-04-26 |