| NPI | 1316987548 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 261003) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 20A9581) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2012-05-04 |