| NPI | 1063443604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 42269) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 227654) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2009-09-21 |