| NPI | 1982952495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 56505) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO 55746) |
| Enumeration Date | 2012-08-15 |
| Last Update Date | 2022-08-22 |