| NPI | 1245302702 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 238549) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: NY 238549-1) |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2017-10-24 |