| NPI | 1164506002 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 229990) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: SC 30352) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2017-04-04 |