| NPI | 1871084509 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RS0010X Internal Medicine, Sports Medicine (Licence: NY 322734) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP04265) |
| Enumeration Date | 2018-05-29 |
| Last Update Date | 2023-10-02 |