| NPI | 1285642959 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 226326) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME117067) |
| 207Q00000X Family Medicine (Licence: NC 2009-01964) | |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2019-02-12 |