| NPI | 1629467493 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 62510) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN FD7082302) |
| Enumeration Date | 2015-01-16 |
| Last Update Date | 2020-08-13 |