| NPI | 1710974530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 028512) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 1763461) |
| Enumeration Date | 2005-10-06 |
| Last Update Date | 2015-09-29 |