| NPI | 1790030849 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME117315) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.019009) |
| Enumeration Date | 2012-07-16 |
| Last Update Date | 2014-09-03 |