| NPI | 1205235231 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA10862000) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 67117) |
| 282N00000X General Acute Care Hospital | |
| Enumeration Date | 2014-08-14 |
| Last Update Date | 2021-03-19 |