| NPI | 1740619956 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PR 19218) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 19218) |
| Enumeration Date | 2013-11-07 |
| Last Update Date | 2016-07-11 |