| NPI | 1760890552 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 290136) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: NY 290136) |
| Enumeration Date | 2014-07-24 |
| Last Update Date | 2017-09-29 |