| NPI | 1265462329 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME112127) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301087399) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2012-03-08 |