| NPI | 1407189681 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD60675906) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR MD162495) |
| Enumeration Date | 2009-09-06 |
| Last Update Date | 2020-12-28 |