| NPI | 1134175086 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 276702) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME68784) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2015-10-05 |