| NPI | 1417231457 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 72110) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 263146) |
| Enumeration Date | 2011-10-10 |
| Last Update Date | 2015-07-16 |