| NPI | 1780658146 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301080105) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI KG080105) |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2023-11-27 |