| NPI | 1851372379 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 226824) |
| Additional Taxonomies | 2083A0100X Preventive Medicine Aerospace Medicine (Licence: NY 226824) |
| Enumeration Date | 2005-11-10 |
| Last Update Date | 2022-11-01 |