| NPI | 1619968021 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A139455) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: NV 11502) |
| 207R00000X Internal Medicine (Licence: NV 11502) | |
| Enumeration Date | 2005-11-03 |
| Last Update Date | 2026-02-27 |