| NPI | 1942568217 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AL 14162) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 26381) | 
| 207R00000X Internal Medicine (Licence: CA G86143) | |
| Enumeration Date | 2012-04-24 | 
| Last Update Date | 2012-04-24 |