| NPI | 1912227414 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME149447) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA08753200) |
| Enumeration Date | 2010-06-07 |
| Last Update Date | 2021-06-29 |