| NPI | 1154776268 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ND 16509) |
| Additional Taxonomies | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: ND 16509) |
| 207Q00000X Family Medicine (Licence: NY 300099) | |
| Enumeration Date | 2016-04-26 |
| Last Update Date | 2021-06-09 |