| NPI | 1467414490 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 245674) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 219138) |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2007-10-05 |