| NPI | 1902079882 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 260094) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01064870A) |
| Enumeration Date | 2008-04-10 |
| Last Update Date | 2018-03-01 |