| NPI | 1962885095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036145430) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.025775) |
| Enumeration Date | 2015-07-07 |
| Last Update Date | 2018-08-31 |