| NPI | 1225088248 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 152171) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 212715) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2025-07-10 |