| NPI | 1598041022 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV 14598) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 263122) |
| Enumeration Date | 2011-10-28 |
| Last Update Date | 2020-12-23 |