| NPI | 1730182577 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 38761) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 182260) |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2015-11-05 |