| NPI | 1194762104 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 283160) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD066919L) |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2024-05-28 |