| NPI | 1366777682 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D0079707) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 2620311) |
| Enumeration Date | 2009-10-04 |
| Last Update Date | 2016-02-29 |