| NPI | 1962608539 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD60624958) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD60624958) |
| 207R00000X Internal Medicine (Licence: HI MDR-5298) | |
| 207RS0010X Internal Medicine Sports Medicine (Licence: HI MD-15762) | |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2021-12-23 |