| NPI | 1154779270 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 318840) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OS0169869) |
| Enumeration Date | 2016-05-31 |
| Last Update Date | 2022-10-17 |