| NPI | 1609138767 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2015-00107) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL UO 3016) |
| Enumeration Date | 2012-06-13 |
| Last Update Date | 2015-11-09 |