| NPI | 1174881031 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 290762) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101259013) |
| Enumeration Date | 2012-04-30 |
| Last Update Date | 2023-01-09 |