| NPI | 1962062679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA OT019305) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL OS18715) |
| Enumeration Date | 2019-06-14 |
| Last Update Date | 2022-08-23 |