| NPI | 1063695971 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 207510) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA07665900) |
| Enumeration Date | 2007-12-13 |
| Last Update Date | 2013-12-03 |