| NPI | 1720474273 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA 304171) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA intern permit pendin) |
| Enumeration Date | 2015-04-11 |
| Last Update Date | 2024-03-07 |