NPI | 1558335174 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 264105) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD424877) |
207Q00000X Family Medicine (Licence: NY 233177-1) | |
Enumeration Date | 2006-02-13 |
Last Update Date | 2015-10-30 |