| NPI | 1801875323 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 219830) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CT 039271) |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2013-10-15 |