| NPI | 1124279583 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME124260) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 267330) |
| 207Q00000X Family Medicine (Licence: NY 267330) | |
| Enumeration Date | 2008-10-03 |
| Last Update Date | 2016-01-30 |