| NPI | 1932331980 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME133465) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 266843) | 
| Enumeration Date | 2009-08-10 | 
| Last Update Date | 2019-10-23 |