| NPI | 1346776218 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X (Licence: KY R4382) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.029841) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2018-07-01 |