| NPI | 1871933598 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301103733) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 6774) |
| Enumeration Date | 2013-06-26 |
| Last Update Date | 2017-11-13 |