| NPI | 1104039593 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A48336) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 34681) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2007-07-08 |