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 |