| NPI | 1417205055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 12402) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 259895) |
| Enumeration Date | 2012-08-28 |
| Last Update Date | 2016-05-31 |