| NPI | 1659651941 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA OP60339102) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL OS11433) |
| Enumeration Date | 2011-08-18 |
| Last Update Date | 2013-06-07 |