| NPI | 1124752613 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD61635170) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 294230) |
| Enumeration Date | 2022-07-12 |
| Last Update Date | 2025-08-10 |