| NPI | 1972593903 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 209216-1) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 2092161) |
| Enumeration Date | 2005-10-21 |
| Last Update Date | 2014-07-01 |