| NPI | 1083894638 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 76444) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR 214779) |
| 207R00000X Internal Medicine (Licence: WA 61425057) | |
| 207R00000X Internal Medicine (Licence: CA A101309) | |
| 261QM2500X Clinic/Center Medical Specialty (Licence: CT 1992372403) | |
| 261QM2500X Clinic/Center Medical Specialty (Licence: NJ 1992372403) | |
| 261QM2500X Clinic/Center Medical Specialty (Licence: NY 1043889967) | |
| Enumeration Date | 2007-11-13 |
| Last Update Date | 2023-11-16 |