| NPI | 1790104008 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 310917) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 310917) |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2024-10-03 |