| NPI | 1720064256 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME152183) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 236304) |
| Enumeration Date | 2005-12-16 |
| Last Update Date | 2025-08-21 |