| NPI | 1902067150 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 048323) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 247824) |
| Enumeration Date | 2008-06-20 |
| Last Update Date | 2010-07-02 |