| NPI | 1770828758 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OK 31973) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301101091) |
| Enumeration Date | 2012-12-03 |
| Last Update Date | 2016-07-07 |