| NPI | 1205288917 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 297127) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 274346-436) |
| Enumeration Date | 2016-07-06 |
| Last Update Date | 2019-06-11 |