| NPI | 1881774610 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 248303) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A69323) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2012-10-15 |