| NPI | 1053769414 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 66405) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP03698) |
| 207R00000X Internal Medicine (Licence: RI MD16578) | |
| Enumeration Date | 2016-05-26 |
| Last Update Date | 2020-08-11 |