| NPI | 1194845628 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME127722) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 047172) |
| 261Q00000X Clinic/Center (Licence: OH 57-009901) | |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2023-03-07 |