| NPI | 1962778951 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD60488974) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA ML 60288352) |
| Enumeration Date | 2012-03-24 |
| Last Update Date | 2016-08-03 |