| NPI | 1417218850 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS13377) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 270415-1) |
| Enumeration Date | 2012-06-01 |
| Last Update Date | 2021-09-02 |