| NPI | 1609097526 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 239687) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OS-014472) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2012-11-14 |