| NPI | 1104322239 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 20100) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OT018606) |
| 207R00000X Internal Medicine (Licence: TX S9922) | |
| Enumeration Date | 2018-04-05 |
| Last Update Date | 2025-06-27 |