| NPI | 1083239958 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WV 36718) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL84453) |
| Enumeration Date | 2020-06-16 |
| Last Update Date | 2026-08-13 |