| NPI | 1578850913 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD60626533) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 275178) |
| Enumeration Date | 2011-07-06 |
| Last Update Date | 2016-08-10 |