| NPI | 1962780940 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 53099) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT198543) |
| Enumeration Date | 2011-07-25 |
| Last Update Date | 2020-02-03 |