| NPI | 1467485490 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 20973) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 009582-1) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2012-06-11 |