| NPI | 1225020001 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 232997) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD424848) |
| Enumeration Date | 2005-08-18 |
| Last Update Date | 2021-09-21 |