| NPI | 1326132804 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 9300327) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: NC 9300327) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2020-10-29 |