| NPI | 1346536604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD173319) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 276654) |
| Enumeration Date | 2011-06-24 |
| Last Update Date | 2015-09-30 |