| NPI | 1053615799 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A 44828) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 161113-1) |
| Enumeration Date | 2011-01-10 |
| Last Update Date | 2011-01-10 |