| NPI | 1679897284 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X (Licence: KS 94-10845) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NV 14813) |
| Enumeration Date | 2010-03-25 |
| Last Update Date | 2022-04-05 |