| NPI | 1215194394 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 245269) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: CT 047158) |
| Enumeration Date | 2008-05-17 |
| Last Update Date | 2022-10-27 |