| NPI | 1063410827 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 073157) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 246485) |
| Enumeration Date | 2005-07-14 |
| Last Update Date | 2022-01-10 |