| NPI | 1063707859 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0102205892) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OT014059) |
| Enumeration Date | 2011-06-09 |
| Last Update Date | 2024-05-10 |