| NPI | 1053522839 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME102753) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57010095) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2012-10-16 |