| NPI | 1972815678 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 03791) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0116022869) |
| Enumeration Date | 2010-07-10 |
| Last Update Date | 2016-02-05 |