| NPI | 1164803011 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X (Licence: MA 282737) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2015018125) |
| Enumeration Date | 2015-06-17 |
| Last Update Date | 2025-07-22 |