| NPI | 1396062287 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL 139734) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 263649) |
| Enumeration Date | 2010-04-30 |
| Last Update Date | 2019-05-15 |