| NPI | 1184200131 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 339978-01) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301511375) |
| Enumeration Date | 2021-03-21 |
| Last Update Date | 2026-02-25 |