| NPI | 1063413805 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 51162) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 228018) |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2020-11-05 |