| NPI | 1730613712 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 314406) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 420866010628) |
| Enumeration Date | 2017-04-17 |
| Last Update Date | 2025-04-29 |