| NPI | 1821122896 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 212478) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: NY 212478) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2012-09-19 |