| NPI | 1053313718 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL 63562) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA04648600) |
| Enumeration Date | 2005-08-12 |
| Last Update Date | 2021-06-19 |