| NPI | 1134117385 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL ME99971) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME99971) |
| Enumeration Date | 2005-10-12 |
| Last Update Date | 2017-03-17 |