| NPI | 1477745222 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA 303347) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA A105625) |
| Enumeration Date | 2007-08-15 |
| Last Update Date | 2014-07-09 |