| NPI | 1992158547 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 282N00000X General Acute Care Hospital (Licence: MA 268008) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 86500) |
| Enumeration Date | 2016-07-19 |
| Last Update Date | 2021-11-15 |