| NPI | 1073166393 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA RN2331017) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 344590) |
| Enumeration Date | 2019-07-17 |
| Last Update Date | 2020-02-25 |