| NPI | 1881073740 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 294692) |
| Additional Taxonomies | 251300000X Local Education Agency (LEA) |
| Enumeration Date | 2015-05-26 |
| Last Update Date | 2018-09-13 |