| NPI | 1841601143 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 61300) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT206151) | 
| Enumeration Date | 2014-05-08 | 
| Last Update Date | 2019-07-01 |