| NPI | 1043210230 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 205450) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 205450-1) |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2012-09-24 |