| NPI | 1619222411 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL me121841) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.020758) |
| 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: FL me121841) | |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2022-11-14 |