| NPI | 1639395064 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D74014) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP00836) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2015-01-21 |