| NPI | 1063862480 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 5101022711) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NH 33724) |
| Enumeration Date | 2016-06-16 |
| Last Update Date | 2024-10-04 |