| NPI | 1528255890 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME113560) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 245688) |
| Enumeration Date | 2007-10-01 |
| Last Update Date | 2017-09-01 |