| NPI | 1912128919 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301091749) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD431390) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2020-01-29 |