| NPI | 1053511691 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 258923) |
| Additional Taxonomies | 207QG0300X Family Medicine Geriatric Medicine (Licence: NY 258923) |
| 207Q00000X Family Medicine (Licence: ME 018618) | |
| 207QG0300X Family Medicine Geriatric Medicine (Licence: NJ 25MA09000900) | |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2013-05-30 |