| NPI | 1053843391 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 83216) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 295519) |
| Enumeration Date | 2017-03-28 |
| Last Update Date | 2025-12-18 |