| NPI | 1205097706 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 2444921) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA os015101) |
| Enumeration Date | 2008-06-18 |
| Last Update Date | 2018-03-30 |