| NPI | 1962498014 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD00031216) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 35020) |
| Enumeration Date | 2005-09-23 |
| Last Update Date | 2020-10-07 |