| NPI | 1962765271 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2015005959) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MO 2015005959) |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2022-09-01 |