| NPI | 1962815852 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MS 28681) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 2897171) |
| Enumeration Date | 2014-06-09 |
| Last Update Date | 2022-04-11 |