| NPI | 1972864304 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR MD184953) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 60212) |
| Enumeration Date | 2012-06-01 |
| Last Update Date | 2018-07-13 |