| NPI | 1245526664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 276488) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AR E8719) |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2014-08-05 |