| NPI | 1962797712 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 80472) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD D0078453) |
| 207R00000X Internal Medicine (Licence: SC LL33533) | |
| Enumeration Date | 2011-06-09 |
| Last Update Date | 2020-01-15 |