| NPI | 1407892268 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 52931) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 233212) |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2018-07-02 |