| NPI | 1083680656 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 167849) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 167849-2) |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2009-03-17 |