| NPI | 1972827913 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR DO166161) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA OP60356174) |
| Enumeration Date | 2010-03-19 |
| Last Update Date | 2017-04-03 |