| NPI | 1902191083 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD61294207) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A131259) |
| Enumeration Date | 2011-06-16 |
| Last Update Date | 2023-06-15 |