| NPI | 1649591686 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 45916)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY R2388)  | 
| 207R00000X Internal Medicine (Licence: FL TRN15210)  | |
| Enumeration Date | 2010-06-14 | 
| Last Update Date | 2021-01-22 |