| NPI | 1700404472 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD489705) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT221647) |
| Enumeration Date | 2020-07-09 |
| Last Update Date | 2025-12-15 |