| NPI | 1609132687 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 276847) |
| Additional Taxonomies | 2083P0011X Preventive Medicine Undersea and Hyperbaric Medicine (Licence: NY 276847) |
| Enumeration Date | 2012-04-04 |
| Last Update Date | 2021-05-06 |