| NPI | 1164576062 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 036441) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL 113731) |
| 207R00000X Internal Medicine (Licence: KY 45523) | |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2015-05-19 |