| NPI | 1306211834 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 295169) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD470290) |
| Enumeration Date | 2015-12-09 |
| Last Update Date | 2021-01-19 |