| NPI | 1376642157 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 253523) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 168171) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2013-01-21 |