| NPI | 1063656411 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME148665) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 270337) |
| Enumeration Date | 2009-04-29 |
| Last Update Date | 2022-03-05 |