| NPI | 1740396415 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR MD23722) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD00042369) |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2007-07-13 |