| NPI | 1578541371 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 212444-1) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CT 054328) |
| 207Q00000X Family Medicine (Licence: FL 109366) | |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2018-09-07 |