| NPI | 1083062103 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 2978261) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD K260839027630) |
| Enumeration Date | 2016-05-31 |
| Last Update Date | 2021-03-19 |