| NPI | 1659465680 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PR 8834) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 164035) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2008-03-18 |