| NPI | 1003445966 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 337434) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 337434-01) |
| Enumeration Date | 2020-04-03 |
| Last Update Date | 2025-07-29 |