| NPI | 1073567723 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME84244) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 218082) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2016-07-07 |