| NPI | 1629166574 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 047385) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL TRN7901) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2012-10-04 |