| 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 |