| NPI | 1225425663 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 293874-1) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 293874) |
| Enumeration Date | 2015-04-23 |
| Last Update Date | 2020-07-01 |