| NPI | 1053806125 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 311417) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301115922) |
| Enumeration Date | 2018-06-29 |
| Last Update Date | 2021-07-31 |