| NPI | 1104964527 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AK AK3428) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA G075469) |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2014-09-18 |