| NPI | 1073502142 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 10194) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME81634) |
| 207R00000X Internal Medicine (Licence: HI 4617) | |
| 207R00000X Internal Medicine (Licence: CA A31720) | |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2008-03-04 |