| NPI | 1609154186 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 261317) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 269435-1) |
| Enumeration Date | 2011-08-01 |
| Last Update Date | 2014-12-11 |