| NPI | 1417233644 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AL 40983) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 60281-20) |
| Enumeration Date | 2011-11-02 |
| Last Update Date | 2020-08-31 |