| NPI | 1497196471 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 079272) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 289426) |
| Enumeration Date | 2013-07-08 |
| Last Update Date | 2025-08-19 |