| NPI | 1053597005 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 109518) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 243128) |
| 207RS0010X Internal Medicine, Sports Medicine (Licence: CA 109518) | |
| Enumeration Date | 2008-01-20 |
| Last Update Date | 2023-12-22 |