| NPI | 1801052253 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 265367) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2011-01940) |
| 207QA0505X Family Medicine, Adult Medicine (Licence: NY 265367) | |
| Enumeration Date | 2008-08-05 |
| Last Update Date | 2019-02-19 |