| NPI | 1629016019 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NH 12446) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2002021785) |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2013-03-25 |