| NPI | 1275635559 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DC MD30307) |
| Additional Taxonomies | 302F00000X Exclusive Provider Organization (Licence: MD D0058776) |
| 302F00000X Exclusive Provider Organization (Licence: DC MD30307) | |
| 302F00000X Exclusive Provider Organization (Licence: VA 0101056019) | |
| 302R00000X Health Maintenance Organization (Licence: DC MD30307) | |
| 302R00000X Health Maintenance Organization (Licence: VA 0101056019) | |
| 302R00000X Health Maintenance Organization (Licence: MD D0058776) | |
| 305R00000X Preferred Provider Organization (Licence: DC MD30307) | |
| 305R00000X Preferred Provider Organization (Licence: VA 0101056019) | |
| 305R00000X Preferred Provider Organization (Licence: MD D0058776) | |
| 305S00000X Point of Service (Licence: DC MD30307) | |
| 305S00000X Point of Service (Licence: VA 0101056019) | |
| 305S00000X Point of Service (Licence: MD D0058776) | |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2017-08-24 |