| NPI | 1114297157 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: CT 55584) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD452749) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: PA MD452749) | |
| 261QP2300X Clinic/Center, Primary Care (Licence: CT 55584) | |
| 207R00000X Internal Medicine (Licence: CT 255766) | |
| Enumeration Date | 2012-01-09 |
| Last Update Date | 2019-10-08 |