| NPI | 1790870723 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VT 042.0012529) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 223593) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2012-10-16 |