| NPI | 1457767634 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 75792) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 57004) |
| Enumeration Date | 2014-07-08 |
| Last Update Date | 2021-12-21 |