| NPI | 1265847164 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 278994) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP03200) |
| Enumeration Date | 2014-06-30 |
| Last Update Date | 2019-09-03 |