| NPI | 1144571662 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OK 30576)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 275847)  | 
| Enumeration Date | 2012-09-24 | 
| Last Update Date | 2021-08-25 |