| NPI | 1710064761 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 243930) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35088229) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2011-12-28 |