| NPI | 1003043209 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 311414) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 241313) |
| Enumeration Date | 2009-06-15 |
| Last Update Date | 2021-07-26 |