| NPI | 1518187822 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D0066434) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 214300) |
| Enumeration Date | 2007-04-27 |
| Last Update Date | 2008-03-11 |