| NPI | 1124559653 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 292551) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 303726) |
| Enumeration Date | 2017-03-26 |
| Last Update Date | 2025-01-21 |