| NPI | 1790193746 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME140818) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 294388) |
| Enumeration Date | 2014-07-22 |
| Last Update Date | 2019-08-25 |