| NPI | 1790232213 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PR 19564) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 111138) |
| 207P00000X Emergency Medicine (Licence: PR 19564) | |
| 208D00000X General Practice (Licence: PR 19564) | |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2026-05-05 |