| NPI | 1013162619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 257815-1) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 257815) |
| Enumeration Date | 2008-11-24 |
| Last Update Date | 2010-10-01 |