| NPI | 1003482621 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 332571) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 12850) |
| Enumeration Date | 2021-06-03 |
| Last Update Date | 2024-10-21 |