| NPI | 1164144747 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: NY 350100) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 350100) |
| Enumeration Date | 2022-09-12 |
| Last Update Date | 2022-09-12 |