NPI | 1982974739 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA09587100) |
Additional Taxonomies | 261Q00000X Clinic/Center (Licence: NY 265909) |
Enumeration Date | 2012-01-11 |
Last Update Date | 2018-05-10 |