| NPI | 1093178717 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD484522) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 296600) |
| Enumeration Date | 2016-03-30 |
| Last Update Date | 2026-01-30 |