| NPI | 1760774426 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NR0400X (Licence: FL HCC9127) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL HCC9127) |
| Enumeration Date | 2011-05-12 |
| Last Update Date | 2013-04-29 |