| NPI | 1912163767 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD60161663) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA ML60019782) |
| Enumeration Date | 2008-07-31 |
| Last Update Date | 2016-12-21 |