NPI | 1417136086 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 41773) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 049920) |
207R00000X Internal Medicine (Licence: OH 35. 072880) | |
208D00000X General Practice (Licence: MS 16175) | |
Enumeration Date | 2007-10-30 |
Last Update Date | 2012-03-08 |