| NPI | 1275860595 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 281P00000X Chronic Disease Hospital (Licence: NY 305185) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: NY 305165) |
| Enumeration Date | 2009-11-06 |
| Last Update Date | 2011-07-15 |