| NPI | 1184862179 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 219718) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CT 045745) |
| Enumeration Date | 2009-01-28 |
| Last Update Date | 2011-06-27 |