| NPI | 1861787152 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA OT013943) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OS017060) |
| Enumeration Date | 2011-06-14 |
| Last Update Date | 2014-06-09 |