| NPI | 1023038957 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 239181) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 228006) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2025-01-28 |