| NPI | 1114965019 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 247050) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 80340) |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2015-05-04 |