| NPI | 1336554468 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0078104) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101257192) |
| Enumeration Date | 2014-06-27 |
| Last Update Date | 2018-06-01 |