| NPI | 1578561015 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: MI 4301064427) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI AP064427) |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2017-02-08 |