| NPI | 1063969012 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PR 21597) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A156932) |
| Enumeration Date | 2016-09-07 |
| Last Update Date | 2022-01-11 |