| NPI | 1518100528 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CT 051182) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 260636-1) |
| Enumeration Date | 2009-04-07 |
| Last Update Date | 2016-01-21 |