| NPI | 1053769315 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD468502) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT211835) |
| Enumeration Date | 2016-05-27 |
| Last Update Date | 2019-10-21 |