| NPI | 1912209115 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME116929) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 7484) |
| Enumeration Date | 2010-11-22 |
| Last Update Date | 2015-06-24 |