| NPI | 1255446647 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 050740) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 186725) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2012-02-16 |