| NPI | 1932342425 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 248667) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101242618) |
| 207Q00000X Family Medicine (Licence: CT 045957) | |
| Enumeration Date | 2009-04-13 |
| Last Update Date | 2013-08-29 |