| NPI | 1851614200 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: NY 152323) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 152323) |
| Enumeration Date | 2010-03-11 |
| Last Update Date | 2010-03-11 |