| NPI | 1417142324 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 269017) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME99769) |
| Enumeration Date | 2007-09-13 |
| Last Update Date | 2014-06-26 |