| NPI | 1265720619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 262602) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: NY 262602) |
| 282N00000X General Acute Care Hospital (Licence: NY 262602) | |
| Enumeration Date | 2011-07-19 |
| Last Update Date | 2016-01-27 |