| NPI | 1356745319 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2019-01846) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 20107) |
| Enumeration Date | 2014-10-20 |
| Last Update Date | 2019-10-01 |