| NPI | 1942419841 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QP2400X Clinic/Center, Prison Health (Licence: PR 5888) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR 5888) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2012-03-12 |