| NPI | 1871553206 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 24579) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 152656) |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2015-10-01 |