| NPI | 1932112893 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME87666) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 222179) |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2020-12-23 |