| NPI | 1972536597 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OK 25323) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM MD2006-0221) |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2020-03-04 |