| NPI | 1912122516 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2008-00452) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP00080) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2010-03-05 |