| NPI | 1912963109 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A9655) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 195326) |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2019-01-15 |