| NPI | 1366584104 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 27836) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 19595) |
| 207R00000X Internal Medicine (Licence: NY 195501) | |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2007-07-08 |