| NPI | 1962899765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 52113) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME129218) |
| Enumeration Date | 2015-04-20 |
| Last Update Date | 2021-07-28 |