| NPI | 1235126491 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2018-01819) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036156671) |
| 207R00000X Internal Medicine (Licence: CT 040729) | |
| 207R00000X Internal Medicine (Licence: GA 80610) | |
| Enumeration Date | 2005-10-03 |
| Last Update Date | 2022-01-21 |