| NPI | 1114480936 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 325733) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ R77327) |
| Enumeration Date | 2019-04-09 |
| Last Update Date | 2023-09-01 |