| NPI | 1093794828 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 226707) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: NY 226707) |
| 208D00000X General Practice (Licence: NY 226707) | |
| Enumeration Date | 2006-01-11 |
| Last Update Date | 2014-04-24 |