| NPI | 1053503540 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NM MD2015-0412) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: LA MD.199997) |
| Enumeration Date | 2007-08-17 |
| Last Update Date | 2019-07-02 |