| NPI | 1104909936 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR MD23268) |
| Additional Taxonomies | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: OR MD23268) |
| 207RA0201X Internal Medicine, Allergy & Immunology (Licence: WA MD00045453) | |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2020-10-05 |