| NPI | 1790179265 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 291503) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 54019) |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2019-06-14 |