| NPI | 1578818787 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A152300) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 281346-1) | 
| Enumeration Date | 2012-07-14 | 
| Last Update Date | 2019-08-08 |