| NPI | 1619087194 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01060837A) | 
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: IN 01060837) | 
| Enumeration Date | 2006-08-30 | 
| Last Update Date | 2008-04-19 |