| NPI | 1659713584 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WV 27577) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT205046) |
| Enumeration Date | 2013-07-19 |
| Last Update Date | 2018-03-17 |