| NPI | 1508358789 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: SC 90062) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OT018407) |
| Enumeration Date | 2018-06-04 |
| Last Update Date | 2023-11-01 |