| NPI | 1669640553 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 258147) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OS014308) |
| 207Q00000X Family Medicine (Licence: CT 52038) | |
| Enumeration Date | 2008-02-14 |
| Last Update Date | 2014-02-25 |