| NPI | 1912063124 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 027195) |
| Additional Taxonomies | 208D00000X General Practice (Licence: GA 027195) |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2021-10-27 |